Provider Demographics
NPI:1497460406
Name:ABDULAHAD, SAMAN
Entity Type:Individual
Prefix:
First Name:SAMAN
Middle Name:
Last Name:ABDULAHAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 MCDOUGALL DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ND
Mailing Address - Zip Code:58504-9134
Mailing Address - Country:US
Mailing Address - Phone:701-471-0269
Mailing Address - Fax:
Practice Address - Street 1:71 MCDOUGALL DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ND
Practice Address - Zip Code:58504-9134
Practice Address - Country:US
Practice Address - Phone:701-471-0269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant